Archived: Bespoke Care At home

Updated 29 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an announced inspection which was carried out by one inspector and took place on 15, 16 & 17 February 16. The provider was given 48 hours’ that the inspection was going to take place. We gave them notice to ensure there would be senior management available at the service’s office to assist us in accessing information we required during the inspection.

Before the inspection we reviewed all the information we held about the service. We looked at notifications the provider was legally required to send us. Notifications are information about certain incidents, events and changes that affect a service or the people using it.

The provider did not complete a Provider Information Return (PIR) as this was not requested prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We visited two people in their homes. We spoke with two relatives and three people who used the service by telephone; two care workers and the registered manager. We looked at five care records, three staff records and records relating to the management of the service.

Updated 29 April 2016

Bespoke Care At Home is registered to provide domiciliary care to older people who require support and assistance in their homes. At the time of our inspection there were 37 people using the service.

The registered manager has been in post since December 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the

service is run.

People and their relatives felt staff were caring, respectful and listened to what they had to say. This was observed during our visit to one person’s home. People were involved in decisions in regards to their care; exercised choice and were encouraged to maintain their independence. Staff ensured people’s dignity was respected when carrying out personal care. People said this was carried out in a dignified way. Staff had developed good working relationships with the people they provided care and support to. Care records evidenced staff were aware of what was important to people. This included their social histories; hobbies and their preferences.

People felt safe with the care provided and knew what to do if they had concerns. Staff had attended relevant training and demonstrated a good understanding of how to keep people safe from abuse. Risk management plans were put in place when risks were identified. These clearly outlined what staff needed to do to minimise the risks. The service ensured staff administered medicines safely. Training records showed staff had attended relevant training and people said the support they received with their medicines was appropriate. The service carried out safe recruitment practices which ensured people were cared for by staff who were of good character. We observed there was sufficient staff to provide care and support to people; this was supported by our review of staff rosters.

People received care and support from staff who received appropriate induction; training; supervision and appraisal. This was supported by our reviews of staff records and what people had told us. Staff demonstrated a good understanding of how to work with people who were unable to make specific decisions. However, we noted mental capacity assessments were not undertaken when people were not able to make specific decisions. We have made a recommendation for the service to seek current guidance on how to carry out mental capacity assessments in line with the Mental Capacity Act 2005 (MCA).

People said staff asked for their consent before care was delivered, a review of their care records supported this. People were effectively supported to eat well balanced meals and received support from the service to access other health professionals.

People felt the care delivered was specific to their individual needs. Initial assessments ensured the service captured essential information about people in order to establish what their care and support needs were. People said staff were responsive to their needs and review of care meetings enabled them to communicate if changes in care their care and support needs was required. Care plans and risk assessment were regularly reviewed for their effectiveness and where there were changes in people’s care and support needs, these were clearly recorded in people’s care records.

People and their relatives knew how to raise concerns and the complaints log evidenced all complaints received were responded to in line with the service’s complaint policy and procedure.

People and their relatives felt the service was well managed. Staff felt supported and said they were kept up to date with changes, able to provide feedback to management and due to this, changes to work practices had been made. The service sought feedback from people using various methods such as unannounced spot checks and weekly telephone calls. This enabled the service to make necessary changes to people’s care needs and current work practices where required.

The service had effective quality assurance systems in place to improve the quality and safety of people who used the service. These were regularly monitored and reviewed for their effectiveness.